Over the past decade, transplantation of vascularized composite allografts (VCAs) such as hand and face transplants has become a clinical reality and a vivid treatment option for those patients in need suffering from complex tissue injuries of defects not amenable to conventional reconstruction. Despite the fact that early and intermediate functional outcomes are highly encouraging rejection, the need for chronic immunosuppressive treatment continues to be the bane of VCA preventing broader clinical application. Therefore, a thorough understanding of the immunogenicity and the basic mechanisms of an alloimmune response in VCA is a key to establish novel protocols for immunomodulation and tolerance induction after VCA without the need for long-term immunosuppression and hence favoring the delicate balance of risks and benefits for such non-life-saving types of transplants.

We invite investigators to contribute original research as well as review articles that will stimulate the continuing efforts to understand the unique immunological features of vascularized composite allografts as well as their individual components, the immunological differences compared to solid organ transplants, the molecular mechanisms and underlying pathology of skin rejection, and the development of novel strategies to avoid rejection and induce tolerance. Potential topics include, but are not limited to:

• Research tools and animal models to study VCA immunology
• Unique immunological features of VCA as compared to solid organ transplants
• Advances in diagnosing skin rejection and immune monitoring
• Tolerance protocols for VCA
• Role of vascularized bone marrow and immunoregulatory stem cells
• The influence of skin-specific antigen-presenting cells on VCA immunogenicity
• Mechanisms of cellular- and antibody-mediated immune responses in acute and chronic rejection of VCA

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